4900:C5 Enteral & Parenteral Nutrition Support Flashcards
bolus feedings
rapid administration of 250-500mL of formula several times daily.
colonocyte
epithelial cell of the large intestine or colon
enteral nutriton (EN)
feeding through the gastrointestinal tract using a tube, catheter, of stoma that delivers nutrients distal to the oral cavity.
gastrostomey
an opening into the stomach
implantable port
intravenous access device that is completely under the skin, is placed in the vein on the upper chest wall, and exits the body near the typhoid process, axilla, or abdominal wall
intermittent feedings
administration of formula several times daily, over 20-30 minutes
nasointestinal feeding tube
a tube that is inserted nasally past the stomach into the intestine.
orogastric feeding tube
a tube that is inserted orally into the stomach
osmolality
number of water attracting particles per wt of water in kg
osmolarity
number of millimoles of liquid or solid in a liter of solution.
parenteral nutriton (PN)
administration of nutrition directly into the circulatory system
percutaneous endscopic gastrostomey (PEG)
a procedure used by a physician to insert a feeding tube through the skin and into the stomach using an endoscope.
peripherally inserted central catheter (PICC)
intravenous access device inserted into the arm and threaded into the subclavian vein to the vena cava.
propofol
lipid based drug that is used to maintain sedation during mechanical ventilation. Also, must be considered as a source of energy.
refeeding syndrome
metabolic alterations that may occur during nutritional repletion of starved patients. Electrolytes involved: Phosphorous, Mg, K and thiamin, need for all increases with return to metabolism of glucose.
ostomy
an artificial opening created by surgical procedure.
stylet
wire guide within the enteral tube that assists with insertion.
tunneled catheter
intravenous access device that is placed in the vein on the upper chest wall and exits the body near the typhoid process, axilla, or abdominal wall.
nasogastric feeding tube
A tube that is inserted nasally into the stomach. Uses when GI function is normal.
Advantages of a nasogastric tube
Uses & stimulates normal digestive function; flexibility in administration; medication can be placed in this tube; tube insertion at bedside.
Disadvantages of nasogastric tube
Aspiration; discomfort for pt; nasal irritation; tube displacement
Nasoduodenal feeding tube used when?
Normal sm intestine function; need to bypass stomach as primary site of feeding
Advantages & disadvantages of nasoduodean tube
A: tube insertion at bedside. D: discomfort for pt; tube displacement
Nasojejunal tube Indications?
Norma sm intestine function; need to bypass stomach as primary site of feeding.
Advantages & disadvantages of Nasojejunal tube
A: tube insertion at bedside. D: discomfort for pt; tube displacement
Gastrostomy indications
Normal GI function but need to bypass upper GL tract; long-term feeding access.
Advantages of gastrostomy
Longer-term feeding access; reduced risk of tube displacement; allows for bolus feeding
Disadvantages of gastrostomy
surgical procedure; risk if irritation and infection for insertion site.
PEG (percutaneous endoscopic gastrostomy) indications
Normal GI function but need to bypass upper GI tract; longer-term feeding access.
Advantages of PEG
Outpatient procedure without risk of anesthesia; longer-term feeding access; less expensive than surgical insertion; reduced risk of tube displacement; allows for bolus feedings
Disadvantages of PEG
risk of irritation and infection for insertion site.
Jejunostomy indications
Normal GI function but need to bypass components of GI tract; longer-term feeding access
Advantages of Jejunostomy
Increased tolerance for early initiation of enteral feeding
Disadvantages of jejunostomy
surgical procedure; risk of irritation & infection for insertion site; with smaller lumen of tube, the risk of clogging may be greater
Protein content of enteral formulas
10-15%. Up to 25% for high PRO needs
medical foods
Foods administered under the supervision of a physician & intended for the specific dietary management of a disease for which distinctive nutritional requirements are established.
Feeding tubes outer diameter is measured in?
French size. 1 Fr = .33 mm. Most are 10-14Fr
Step : Enteral Nutrition Rx
Determine a “dosing” wt. What is the pt’s ideal body wt?
Step 2 & 3: Enteral Nutrition Rx
- Determine a kcal goal. 25-30kcal/kg, &/or use Mifflin-St. Jeor 3. Adjust for activity and injury as needed.